Chronic Disease Model of Shared Care after Obesity and Metabolic Surgery
We thank the authors for their interest in the IFSO global registry report and their comments on provision of long-term follow-up, a challenge largely unmet by healthcare systems in patients undergoing obesity and metabolic surgery [1, 2]. Given that long-term survival is expected and even improved afterwards, surgeons and programs need to work with other healthcare professionals to formulate and deliver appropriate follow-up pathways. There are lessons to be learned from other models of shared care such as transplant, cardiothoracic, endocrine and cancer surgery . For example, after colorectal cancer resection surveillance colonoscopy, sequential imaging and oncology follow-ups are considered standard care. Post-operative care of bariatric surgery patients needs to be similarly embedded into different healthcare systems.
In the current 2013 UK National Health Service England Commissioning Policy, the surgical unit and the weight assessment and management clinics (WAMCs) share the...
The IFSO Global Registry Second Report was funded by the International Federation for Surgery for Obesity and Metabolic Disorders.
Compliance with Ethical Standards
Conflict of Interest
Dimitri J. Pournaras declares no conflict of interest.
Richard Welbourn declares support for attending conferences from Ethicon Endo-Surgery, consultancy fees from Novo Nordisk, funding of a Bariatric Clinical Fellow in Musgrove Park Hospital from Ethicon Endo-Surgery, outside the submitted work.
- 1.Welbourn R, Pournaras DJ, Dixon J, Higa K, Kinsman R, Ottosson J, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the second IFSO Global Registry Report 2013-2015. Obes Surg 2017.Google Scholar
- 2.How can we manage long-term follow-up after obesity and metabolic surgery? Obes Surg. 2017. In press.Google Scholar
- 4.Welbourn R, Hopkins J, Dixon JB, et al. On behalf of the Guidance Development Group. Commissioning guidance for weight assessment and management in adults and children with severe complex obesity. Obes Rev. 2017; https://doi.org/10.1111/obr.12601.
- 5.National Institute for Health and Clinical Excellence. Guidance CG189. In: Obesity: identification, assessment and management of overweight and obesity in children, young people and adults: partial update of CG43. National Clinical Guideline Centre: London, 2014.Google Scholar
- 9.Welbourn R, le Roux CW, Owen-Smith A, et al. Why the NHS should do more bariatric surgery; how much should we do? BMJ (Clin Res ed). 2016;i1472:353.Google Scholar